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Tenotomía Percutánea Guiada por Ultrasonido para el Dedo en Gatillo: Un Caso Ambulatorio Mínimamente Invasivo
Nicholas Lorenz1, Amia Mourad1, Stephen Westfall2
1Medical School, Lake Erie College of Osteopathic Medicine, Bradenton, USA.
Cureus
|February 2, 2026
Resumen
La tenotomía de la polea A1 guiada por ultrasonido ofrece un tratamiento mínimamente invasivo seguro y eficaz para el dedo en gatillo cuando fallan los métodos conservadores. Este procedimiento resuelve rápidamente el dolor y restaura la función, proporcionando una solución ambulatoria eficiente.
Área de la Ciencia:
- Ortopedia
- Medicina Musculoesquelética
- Radiología Intervencionista
Sus antecedentes:
- El dedo en gatillo (tenosinovitis estenosante) se trata comúnmente con medidas conservadoras e inyecciones de corticosteroides.
- La cirugía generalmente se reserva para casos refractarios al manejo no operatorio.
- La tenotomía percutánea guiada por ultrasonido es una técnica emergente mínimamente invasiva.
Objetivo del estudio:
- Presentar un caso de fenestración exitosa de la polea A1 guiada por ultrasonido con inyección de corticosteroides para el dedo en gatillo refractario.
- Evaluar la seguridad, eficiencia y efectividad clínica de este enfoque mínimamente invasivo.
Principales métodos:
- A un paciente varón de 70 años con dedo en gatillo Grado 3 y Grado 2 se le realizó una fenestración de la polea A1 guiada por ultrasonido combinada con inyección de corticosteroides.
- El procedimiento permitió la visualización directa de la polea A1, los tendones flexores y las estructuras neurovasculares.
Principales resultados:
- El paciente experimentó una resolución completa del dolor, el "triggering" y la limitación funcional en las dos semanas posteriores al procedimiento.
- La intervención demostró ser segura y eficiente.
Conclusiones:
- La tenotomía de la polea A1 guiada por ultrasonido es una intervención ambulatoria segura, eficiente y clínicamente eficaz para el dedo en gatillo.
- Proporciona una opción valiosa para los pacientes que no logran un alivio completo con los tratamientos conservadores.
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